Phyllodes Tumors and Fibroadenoma Common Beginning and Different Ending

Phyllodes tumors and fibroadenomas are the most common benign breast tumors. They arise from intralobular fibrous tissue as a unique lesion and after a period of time they differentiate in two direction: to fibroadenoma and to phyllodes tumors. Fibroadenomas grow up to 2–3 cm and then stop growing but phyllodes tumors grow continually and sometimes are to 40 cm big. Both these lesions have two components, epithelial and stromal. Clinically fibroadenomas are well circumscibed, hard, oval, movable lesions. They can be solitary, multiple, unilateral and bilateral. They are hormone dependent changes, because they change their own consistency during menstrual cycle and gravidity. The most commonly used histological classification is in two types: pericanalicular and intracanalicular type. Phyllodes tumors make about 1% of all breast tumors. This tumor has many synonyms. It starts as fibroadenoma in intralobular stromal component. It has continuous growth and biologically it can be benign, borderline and malignant. The first description is from Miller (1838). The main goal is to find the divergence point when the developing is direct to fibroadenoma or phyllodes tumor. The second goal is to investigate the fate of epithelial and stromal component in these two lesions. Retrospective analysis is made of all fibroadenomas and phyllodes tumors in Pathology Department of Medical Center »Be`anijska kosa« in the period from 1998 to 2006. In this period, 2919 women were operated for breast changes. 343 fibroadenoma (24, 4%), were diagnosed, benign phyllodes tumor in 95 women (6.7%) and malignant phyllodes in 4 cases or 0.2%. All slides from these patients were analysed for many different histological parameters and immunohistological investigation for steroid receptors was also used, c-erbB2 (Her2/Neu), PCNA (proliferative cellular nuclear antigen) and Ki-67, androgen receptor and p53. All data were statistically investigated (Odds ratio, confidence interval, Fisher exact test, Wilcoxon sum test and Kendall test). It was concluded that fibroadenomas and phyllodes tumors arise from intralobular fibrous tissue, both changes have very close histology in the beginning and divergent growth starts later. Differences are present in stromal component. Phyllodes tumor has two component stroma. Stromal cells in phyllodes tumors are more PCNA positive than in fibroadenomas, also Ki-67 and androgen receptors are more positive in phyllodes tumors. Histologically phyllodes tumors have perforated capsule with finger like projections. These data determine surgical procedure, wide excision in phyllodes and simple excision in fibroadenomas

Influence of Liaison Psychiatric Approach on Quality of Life in Patients with Newly Diagnosed Breast Cancer

Having breast cancer represents traumatic stress event that can influence development of psychiatric disorders during psychological adjustment. The aim of research was to investigate influence of liaison psychiatric approach on quality of life in patients with breast cancer. Sample consisted of 120 women with breast cancer treated on Department for Oncology in University Hospital Osijek. Patients were in liaison psychiatric treatment for two months. They were estimated on the first day, after one and two months of treatment. We used psychiatric interview and DSM-IV criteria, specially structured non-standardized questionnaire for estimation of potential ethyological factors for psychiatric disorders and WHOQOL-BREF for estimation of quality of life. We found that liaison psychiatric approach improved quality of life in patients with newly diagnosed breast cancer

Phyllodes Tumors and Fibroadenoma Common Beginning and Different Ending

Phyllodes tumors and fibroadenomas are the most common benign breast tumors. They arise from intralobular fibrous tissue as a unique lesion and after a period of time they differentiate in two direction: to fibroadenoma and to phyllodes tumors. Fibroadenomas grow up to 2–3 cm and then stop growing but phyllodes tumors grow continually and sometimes are to 40 cm big. Both these lesions have two components, epithelial and stromal. Clinically fibroadenomas are well circumscibed, hard, oval, movable lesions. They can be solitary, multiple, unilateral and bilateral. They are hormone dependent changes, because they change their own consistency during menstrual cycle and gravidity. The most commonly used histological classification is in two types: pericanalicular and intracanalicular type. Phyllodes tumors make about 1% of all breast tumors. This tumor has many synonyms. It starts as fibroadenoma in intralobular stromal component. It has continuous growth and biologically it can be benign, borderline and malignant. The first description is from Miller (1838). The main goal is to find the divergence point when the developing is direct to fibroadenoma or phyllodes tumor. The second goal is to investigate the fate of epithelial and stromal component in these two lesions. Retrospective analysis is made of all fibroadenomas and phyllodes tumors in Pathology Department of Medical Center »Be`anijska kosa« in the period from 1998 to 2006. In this period, 2919 women were operated for breast changes. 343 fibroadenoma (24, 4%), were diagnosed, benign phyllodes tumor in 95 women (6.7%) and malignant phyllodes in 4 cases or 0.2%. All slides from these patients were analysed for many different histological parameters and immunohistological investigation for steroid receptors was also used, c-erbB2 (Her2/Neu), PCNA (proliferative cellular nuclear antigen) and Ki-67, androgen receptor and p53. All data were statistically investigated (Odds ratio, confidence interval, Fisher exact test, Wilcoxon sum test and Kendall test). It was concluded that fibroadenomas and phyllodes tumors arise from intralobular fibrous tissue, both changes have very close histology in the beginning and divergent growth starts later. Differences are present in stromal component. Phyllodes tumor has two component stroma. Stromal cells in phyllodes tumors are more PCNA positive than in fibroadenomas, also Ki-67 and androgen receptors are more positive in phyllodes tumors. Histologically phyllodes tumors have perforated capsule with finger like projections. These data determine surgical procedure, wide excision in phyllodes and simple excision in fibroadenomas

Udio turmoske strome kao loš prognostički čimbenik kod karcinoma debelog crijeva

High stroma proportion appears to be a very important prognostic factor in esophageal and breast cancer. Previous researches have shown that it might have a similar effect on colorectal cancer. The aim of this study was to determine whether tumor stroma proportion influenced patient survival. This retrospective study included 236 patients with colorectal cancer having undergone surgery in 2006 and 2007 at Osijek University Hospital Center. Location with the highest stroma proportion at the site of deepest tumor invasion was determined. Patients were divided into the groups with high stroma proportion (>50%) and low stroma proportion (≤50%). Stroma proportion showed a statistically significant correlation with tumor stage. Kaplan-Meier survival curves yielded a statistically significant difference in patient overall survival (Cox ph model p=0.016) and progressionfree survival (Cox ph model, p=0.0188) according to stroma proportion. Study results showed a statistically significantly shorter overall survival and progression-free survival in patients with high stroma proportion.Dokazano je da je visok udio strome značajan prognostički čimbenik kod karcinoma jednjaka i karcinoma dojke. Prethodna istraživanja su pokazala da bi isti utjecaj stroma mogla imati i kod kolorektalnog karcinoma. Cilj istraživanja je bio utvrditi je li udio tumorske strome povezan s preživljenjem bolesnika s kolorektalnim karcinomom. Provedeno je retrospektivno istraživanje u 236 bolesnika koji su operirani na Klinici za kirurgiju Kliničkoga bolničkog centra Osijek. Određeno je područje s najvećim udjelom strome u području najdubljeg prodora tumora. Bolesnici su podijeljeni u dvije skupine: onu s visokim udjelom strome (>50%) i onu s niskim udjelom strome (≤50%). Udio tumorske strome bio je statistički značajno povezan sa stadijem tumora. Kaplan-Meierova analiza je pokazala statistički značajnu razliku u ukupnom preživljenju (Cox ph model p=0,016) i preživljenju do progresije (Cox ph model, p=0,0188) bolesnika u odnosu na udio strome. Rezultati su pokazali statistički značajno kraće ukupno preživljenje i preživljenje do progresije bolesti kod bolesnika s visokim udjelom strome

Metastaze karcinoma želuca u dojci – prikaz slučaja

Gastric cancer is one of the most common causes of cancer death. In 2005, there were 1059 newly diagnosed cases of gastric cancer in Croatia. Stomach cancer spreads very early and usually to regional lymph nodes and surrounding tissues such as the liver, lungs, or ovaries, and less often to the bones and central nervous system, whereas the breast is very rarely the site of its metastases. Among the available data, we have found only 9 publications describing cases of gastric metastases developed in the breast, we decided to publish this case report presenting a patient who underwent total gastrectomy for gastric cancer in May 2000, and then surgery for metastases of gastric cancer to the breast in January 2005.Karcinom želuca je jedan od vodećih uzroka smrti od karcinoma. U Hrvatskoj je u 2005 godini otkriveno 1059 novih slučajeva karcinoma želuca. Karcinom želuca obično metastazira vrlo rano i to u okolne limfne čvorove, jetru, pluća, jajnike, te rje|e u kosti i središnji živčani sustav, dok je dojka vrlo rijetko sijelo metastaza. U dostupnoj literaturi pronašli smo samo 9 radova koji opisuju širenje karcinoma želuca u dojku, te smo odlučili prikazati slučaj naše pacijentice koja je u svibnju 2000. godine operirana radi karcinoma želuca, a u siječnju 2005. operirana radi metastaze u dojci

Effects of War Aggression in Croatia on Histopathological Manifestations of Breast Cancer in Defined Population of One County

The aim of the present study was to determine the differences in epidemiological and clinical manifestations of breast cancer during the war in Croatia and in peacetime. 660 consecutive patients were recorded (656 female and 4 male patients) from Po`e{ko -Slavonska County. The changes in histopathological features were recorded in war period (1991–1995, 156 patients) and through two control periods, before the war (1981–1990, 282 patients) and after the war (1995–2000, first five months, 223 patients). The relative predictive value was calculated using 2-test. The survival was calculated according to Kaplan-Meier analysis of survival. The histopathological analysis showed an equal distribution of noninvasive cancer (in situ cancer) across periods. In the war period, the level of the most common invasive cancer, ductal breast cancer, was lower (57.7%), compared to control periods (71.2% : 63.7% : 68.2%). Opposite to that, invasive lobular cancer was more common in the war period (3.2%), compared to control periods (0.7%– 1.3%). Furthermore, mixed cancer was also increased in the war period (7.1%) compared to control periods (0.7%–2.2%), as was medullar cancer (10.9% vs. 5.5%–5.9%). The study showed statistically significant differences in the survival of patients with different histopathological diagnoses (Log Rank= 47.49, df=7, p<0.0001), while the histological grade of tumor, as a predictive factor was not proved to be statistically significant (p>0.05). This study confirmed the influence of war on histopathological incidence of some forms of breast cancer

Metastaze karcinoma želuca u dojci – prikaz slučaja

Gastric cancer is one of the most common causes of cancer death. In 2005, there were 1059 newly diagnosed cases of gastric cancer in Croatia. Stomach cancer spreads very early and usually to regional lymph nodes and surrounding tissues such as the liver, lungs, or ovaries, and less often to the bones and central nervous system, whereas the breast is very rarely the site of its metastases. Among the available data, we have found only 9 publications describing cases of gastric metastases developed in the breast, we decided to publish this case report presenting a patient who underwent total gastrectomy for gastric cancer in May 2000, and then surgery for metastases of gastric cancer to the breast in January 2005.Karcinom želuca je jedan od vodećih uzroka smrti od karcinoma. U Hrvatskoj je u 2005 godini otkriveno 1059 novih slučajeva karcinoma želuca. Karcinom želuca obično metastazira vrlo rano i to u okolne limfne čvorove, jetru, pluća, jajnike, te rje|e u kosti i središnji živčani sustav, dok je dojka vrlo rijetko sijelo metastaza. U dostupnoj literaturi pronašli smo samo 9 radova koji opisuju širenje karcinoma želuca u dojku, te smo odlučili prikazati slučaj naše pacijentice koja je u svibnju 2000. godine operirana radi karcinoma želuca, a u siječnju 2005. operirana radi metastaze u dojci

Efficasy of Different Psychiatric Treatment Methods of Liaison Psychiatrist in Treatment of Women with Breast Cancer

Being diagnosed with breast cancer is a traumatic event that can lead to development of different mental disorders and influences all aspects of affected woman’s life. Anxiety and Depressive Disorders in physically ill people still don’t have clear diagnostic criteria which make diagnosis and treatment very difficult since different psychiatric therapeutic approaches have different effects. The aim was to evaluate influence of separate and combined psychotherapeutic approach (psychodynamic and cognitive-behavioural) and psychopharmacotherapy on decrease of anxiety and depression in breast cancer patients. The sample consisted of 120 subjects divided into four groups. The first group of patients was treated with psychopharmacotherapy, the second group recieved psychotherapy, the third group was treated with the combination of psychopharmacotherapy and psychotherapy, and the fourth group of patients didn\u27t receive any kind of psychiatric treatment. We used psychotherapeutic interview with detailed clinical assessment using DSM-IV criteria for mental disorders, specially structured non-standardised questionnaire for assessment of etiological factors in development of mental disorders, Hamilton Anxiety Scale (HAM-A), Hamilton Depression Scale (HAM-D). The subjects filled the questionnaires on entry, one moth and two months after the beginning of research. Psychotherapeutic treatment was conducted once a week. All of the therapeutic approaches of liaison psychiatrist applied in the treatment of women with breast cancer are successful in reduction of anxiety and depression. Liaison psychiatrist\u27s combined approach of psychopharmacological and psychotherapeutic treatment of breast cancer patients with depression obtained better results than separate approach

Unilateral Multicentric Breast Cancer

Clinical characteristics of unilateral multicentric breast cancer (UMBC) were explored depending on aggressiveness, survival rate, disease-free period and local recurrence. The study included 296 women with breast cancer, surgically treated between 1990 and 2001. UMBC was histologically proved in 29 (9.8%) patients. Multicentricity was defined by following criteria: a) tumor with minimum one satellite node in the same or other quadrant of the breast; b) minimum one cut through the breast without tumor cells; c) histopathologically, discontinued tumors with intra-ductal invasion. The average age of patients was 63.4 (range 36–85). There were 9 (31.0%) women with one satellite node, 7 (24.1%) women with two satellite nodes, and 13 (44.8%) women with three or more satellite nodes. At the operation, axilla was positive in 20 (68.9%) women. Steroid receptors were highly positive in 12 (41.4%) patients. Primary and secondary tumors were of the same histological type in 26 (89.6%) patients. Local recurrence was found in only 3 (10.3%) patients. A five-year period without disease was achieved in 24 (82.7%) women. Kaplan-Meier analysis showed a significantly higher survival rate at lower tumor stages (I or II) unlike in advanced stages with predominantly N2 grade. The results of this study showed a slightly lower five-year disease-free period than in the case of patients with monocentric breast cancer (MOBC). The survival rate was significantly lower at all advanced stages, especially determined by N2 axilla. Therefore, the conclusion is that multicentricity doesn’t increase the risk of poor prognosis, especially at lower tumor stages

Effects of War Aggression in Croatia on Some Forms and Manifestations of Breast Cancer

The aim of this study was to determine the differences in epidemiological and clinical manifestations of breast cancer in time of war in Croatia and in peacetime before and after the war, in the defined population of Po`e{ko-Slavonska County. The methods used in this study were the evaluation of relative predictive value of variables by means of 2–test and the analysis of variance, while the survival studies were tested by Long Rank test according to Kaplan-Meier analysis of survival. This work encompasses 660 patients who had breast cancer. The differences between three time periods were evaluated: the war period (1991–1995), and two control periods: before the war (1981–1990) and after the war (1996–2000). The patients were grouped by age, localization of tumor and survival. During the war period the patients were, on the average, 4.2 years younger than those who acquired the disease in control periods, and the mean age of patients was between 50 and 59 years (36.5% of patients). Although the difference in tumor distribution by sides (left or right breast) and quadrants was statistically significant (war period vs. control periods; p<0.001), there was no statistically significant difference in the survival of patients according to the results of Kaplan-Meier analysis of localization of tumor (p>0.05). The length of survival in terms of age of patients in time of surgical procedure was significantly different (p<0.001). This study confirms the effects of war on some epidemiological and clinical manifestation of breast cancer in the defined population of Po`e{ko-Slavonska County